نوع مقاله : گزارش مورد
1 استاد گروه زنان و مامایی، فلوشیپ انکولوژی زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.
2 رزیدنت زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.
3 رزیدنت فلوشیپ انکولوژی زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.
عنوان مقاله [English]
Introduction: Bladder exstrophy is a rare congenital anomaly due to midline anterior abdominal wall defect, causing a series of genitourinary and muscular malformations, which demands surgical correction. Women with bladder exstrophy are fertile and able to have normal children without this disease. However, successful pregnancy and delivery is rare in females with this condition and many complications can occur. Planned Cesarean section at term is considered the most appropriate mode of delivery. In this research, a case with bladder exstrophy, who experienced natural delivery without trauma to the genitourinary system, was introduced.
Case presentation: Our case was a 36-year-old pregnant woman with a history of multiple corrective surgical procedures due to bladder exstrophy, who referred to the hospital with labor pain and rupture of members at 39 weeks of gestation. She had a successful vaginal delivery without complications with the use of sublingual misoprostol and intravenous oxytocin.
Conclusion: Although cesarean section is the most common mode of delivery for pregnant women with bladder exstrophy, it could be associated with risks, including multiple pelvic adhesions due to several corrective surgeries. Therefore, natural vaginal delivery with proper monitoring can be an appropriate method for pregnancy termination in this disease.
Hensle TW, Bingham JB, Reiley EA, Cleary-Goldman JE, Malone FD, Robinson JN. The urological care and outcome of pregnancy after urinary tract reconstruction. BJU Int 2004; 93(4):588-90.